SMYS Nursing Mission – October 2016 – Ketu South District, Volta Region, Ghana
** this article contains some graphic photos of serious health conditions
Five RNs, two NPs, and one all-around helper came from the US to serve four remote villages in SE Ghana over five days. Approximately 850 villagers were examined and treated. The collaboration between Healthy Villages, Inc., Show Me Your Stethoscope (SMYS), and the Ghana Health Service to bring a group of nurses and nurse practitioners to Ghana for a nursing mission was successful beyond any of our wildest dreams!
Home-base was Dogbekope Village, where we were invited to use a large, comfortable family compound on the outskirts of the small village. Our meals were the typical foods of that region, and catered by excellent cooks.
In the evenings, Healthy Villages co-director Godfried Agbezudor answered our volunteers’ questions about the history, culture, traditions and spirituality of the Volta Region. Anything they’d noticed during the day and wondered about led to fascinating discussions that kept everyone spellbound.
The first day, we went to the village of Yama Lente, situated right at the border with Togo. We had quite a few staff from the Ghana Health Service assisting us with interpreting, diagnosis of tropical illnesses, and dispensing meds.
Given that this was the first large-scale health mission for all of us, we had no idea what to expect and were really just sorting out our procedures on the fly – but we all pulled together as a team and day by day we streamlined how we organized ourselves and processed patients. The first day was a little hectic – when we arrived at the village there were at least 100 people already waiting for us to see them!
This was our first exposure to the serious health conditions facing villagers in Ghana. In general, villagers are too poor to go to the health clinic for treatment, so their problems go untreated. With our free services and meds, people came “in their numbers” as they say here, seeking relief from infections, skin wounds, hypertension, and many other conditions that they’d been living with for months or even years.
Each village we went to had its own set of health concerns – Yama Lente (largely a farming village) had a disproportionate number of severe skin wounds, some of which had been present for months, and were still large open sores that had not begun to heal. We set aside one room and two of our nurses as a wound clinic, and they were busy most of the day, attending to wounds and other skin conditions.
A heartbreaking case with (hopefully) a happy ending was a girl of about 8 years old with severe asthma. She could barely get any oxygen into her lungs. Her mom hadn’t been able to afford her asthma medication for the past month. One of our nurses focused on helping this little girl, and the Ghana Health Service director and she took the girl to the hospital (about half an hour away), and bought her the medications she would need. Her mom was educated about the seriousness of her daughter’s need for ongoing medication. At least the child will be better for the next month, giving her parents time to save up money for her next round of meds. We saved this girl’s life, and it made our day!
The second day, we moved to the coast, to the fishing village of Agavedzi. We had to quickly figure out where to set up areas for intake and vitals, exam rooms, and pharmacy. We traveled with our boxes and bags full of donated medical supplies and meds and had to organize them into an outdoor, makeshift dispensing area in a hurry!
We set up a wound care room, but were surprised that wounds were not an issue in this village - so wound care shifted to vitals and taking the patient’s history with the help of an interpreter.
The primary issue facing Agavedzi appeared to be hypertension – with wildly high blood pressures. In most cases, the patients had no idea they had hypertension and had never taken meds for it. We also encountered a predominant misunderstanding that one month’s worth of BP meds would solve their problem – so those who had previously been prescribed medication had taken it for one month and then when the pills ran out, they stopped taking their meds. We dispensed aspirin to lower their risk of stroke, and strongly suggested they go to the local hospital clinic for ongoing treatment and follow-up.
A need for ongoing, affordable healthcare in the remote villages came home again and again. Watch this space, as plans for an upgraded health clinic in Dogbekope develop! We had lots of discussion about the possibilities and how SMYS can be part of continued, sustainable health in the village.
We felt that much could be done by working with the villagers to change eating habits, stay hydrated, and lower salt intake. We survived the hot, humid days in the open-air clinical work by drinking coconut water – a natural way to ward off dehydration. While coconuts grow everywhere, the idea of regularly drinking coconut water was laughable to most of our patients!
The third day took us to another inland farming village, Dodorkope. By now we were hitting our stride, and quickly got set up and started processing patients. I stationed myself at the pharmacy table, putting a small supply of OTC meds in donated empty pill bottles and labeling them with the name and a graphic to show dosage that the patient could understand even if they were illiterate – one circle for “one pill a day”, two circles joined by a line for “one pill twice a day” and so on. The Ghana Health Service pharmacist taught me how to use this graphic, and I thought it was brilliant!
Having Godfried on “crowd control” was another brilliant move – he did a splendid job of making sure no one cut in line, used someone else’s intake booklet to jump the queue, or started making a fuss! You wouldn’t believe how badly the villagers wanted to be seen by American “doctors” – even if they didn’t have any health problems! We had to weed out people with complaints such as “when I lay on my arm, it falls asleep!” This young lady was sent away with the admonition that people with serious conditions were waiting!
At a point, all the students from the nearby school came down and waited in the shade. Given that we had already done intake on over 200 people and it was late in the day, we had to turn them away so we could finish up those we had promised to see. As said, the need is so huge, that we could spend a week in a single village and still not see all those with medical issues.
Wound care and skin conditions were a greater concern, probably related to farming being done mostly by hand with sharp tools. One young man came in limping with a dirty cloth wrapped around a wound that covered his entire lower leg – he’d apparently been playing with gunpowder and had been severely burned. He hadn’t been to the hospital in the eight days since the incident occurred. Surprisingly, the wound wasn’t infected, though infection was a serious concern. Our wound care nurses did what they could, he was dispensed antibiotics, and urged to immediately go to the hospital. We can only hope he will find the means to follow this advice.
Our final two days of clinic were spent in our home-base village, Dogbekope. This is Godfried’s home village and we are well acquainted with the little health clinic and its devoted staff. We wanted to surpass our top number of patients (220 in Dodorkope) and we did – 260 seen! By the end of the clinic we were running out of meds and doing the best we could with a couple too few interpreters, but we made it! Everyone was seen and treated with the utmost of care, compassion, and professionalism. We had our organizational skills ‘down’ too, allowing for streamlined triage, evaluation, and dispensing of medications. We are ready to hit the ground running when we have our next mission trip in April 2017!
Dogbekope’s main health concern was malaria – we had more positive malaria tests here than any of the other villages. This put us all a little on edge, since we were staying in the village and being bitten by the same malaria-carrying mosquitoes. All our volunteers were taking malaria preventative – a real necessity! One little girl with malaria came in with a high fever, dehydrated from vomiting, and totally listless. We went in to the nearby town to get an injectable anti-nausea drug for her and soon after administering it, she could keep water and medication down and was already starting to look a little better.
The days flew by, but we were all totally exhausted from the heat, lack of sound sleep, and the number of severely ill patients we saw each day. Yet no one complained – we all felt humbled by being able to do this work on behalf of those in need, who struggle with poverty every day and have extremely limited resources.
We left the village feeling satisfied to have participated in humanitarian travel the way it should be – a real tangible contribution made in a third world country, while learning about and seeing the culture from an insider’s perspective. This was not a humanitarian mission designed just to make the participants feel good from an ego-based perspective – we dove in head first, got sweaty, did some great work – but we also formed a team, enjoyed each other’s company, and had fun!
Come join us in 2017 for one of our healthcare missions – we are currently planning a general healthcare mission in April, a dental mission in May, and a women’s health mission in September/October. Our calendar is filling up, so if you have an idea for a mission trip, let us know, and we will be happy to coordinate it for you!